PENINSULA PHARMACY INC NPI 1003807413

NPI Information

  • NPI: 1003807413
  • Provider Name: PENINSULA PHARMACY INC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: PENINSULA PHARMACY
  • Address: 1414 W FAIR AVE
    SUITE 133
    MARQUETTE, MI
    ZIP 49855
  • Phone: (906) 225-3902

Map and Directions

Get Directions

NPI Details

PENINSULA PHARMACY INC is a community/retail pharmacy pharmacy in Marquette, MI. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. PENINSULA PHARMACY INC NPI is 1003807413. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Peninsula Pharmacy.

The provider's business location address is:

1414 W FAIR AVE
SUITE 133
MARQUETTE, MI
ZIP 49855-675
Phone: (906) 225-3902
Fax: (906) 226-2661

The provider's authorized official is Praveen Challa .
The authorized official title is President and has the following contact phone number (906) 225-3902.

The enumeration date for this NPI number is 11/3/2005 and was last updated on 12/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1183500000XPharmacist5301010345MICHIGANNo
2332B00000XDurable Medical Equipment & Medical Supplies1199700001MICHIGANNo
3332BP3500XDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition1003807413MICHIGANNo
43336C0003XPharmacyCommunity/Retail Pharmacy5301010345MICHIGANYes
53336H0001XPharmacyHome Infusion Therapy Pharmacy5301010345MICHIGANNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13409001MEDICAIDMICHIGAN
21003807413OTHERMICHIGANBCBS - MICHIGAN
32357362OTHERMICHIGANNCPDP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI